Bayesian regression discontinuity designs: Incorporating clinical knowledge in the causal analysis of primary care data

The regression discontinuity (RD) design is a quasi-experimental design that estimates the causal effects of a treatment by exploiting naturally occurring treatment rules. It can be applied in any context where a particular treatment or intervention is administered according to a pre-specified rule linked to a continuous variable. Such thresholds are common in primary care drug prescription where the RD design can be used to estimate the causal effect of medication in the general population. Such results can then be contrasted to those obtained from randomised controlled trials (RCTs) and inform prescription policy and guidelines based on a more realistic and less expensive context. In this paper we focus on statins, a class of cholesterol-lowering drugs, however, the methodology can be applied to many other drugs provided these are prescribed in accordance to pre-determined guidelines. NHS guidelines state that statins should be prescribed to patients with 10 year cardiovascular disease risk scores in excess of 20%. If we consider patients whose scores are close to this threshold we find that there is an element of random variation in both the risk score itself and its measurement. We can thus consider the threshold a randomising device assigning the prescription to units just above the threshold and withholds it from those just below. Thus we are effectively replicating the conditions of an RCT in the area around the threshold, removing or at least mitigating confounding. We frame the RD design in the language of conditional independence which clarifies the assumptions necessary to apply it to data, and which makes the links with instrumental variables clear. We also have context specific knowledge about the expected sizes of the effects of statin prescription and are thus able to incorporate this into Bayesian models by formulating informative priors on our causal parameters.Comment: 21 pages, 5 figures, 2 table

Applying ecosystem services assessment in closure planning to enhance post-mining land-use outcomes: learning from bauxite mining in Brazil and Australia

Ecosystem services assessments help us understand the benefits that society obtains from ecosystems, and they are increasingly being used to understand the human–nature relationship in many applications. This paper presents the results of two ecosystem services assessments applied as part of mine closure planning and rehabilitation activities for two bauxite mining operations operated by the same company, one located in Brazil, the other in Australia. The focus was on the value of the postmining land use that was being realised for local community users. For the Juruti mine site, located in Amazon rainforest, the research examined the return of culturally and economically important forest products—such as Brazil nuts, natural fruits and timber—to local communities living in the vicinity of the mining operations. For the Australian operation, located in the jarrah forest of Western Australia, the research focused on recreationists’ perceptions of the value of rehabilitated bauxite mine areas for bushwalking and mountain biking. Interviews were the principal method employed to understand community stakeholder interactions with pre-mining and post-rehabilitation areas. Workshops were conducted with regulators responsible for mine closure planning and rehabilitation activity.In the Brazil case, taking an ecosystem services approach to explain and explore the mine closure planning process with both the community and the mining company alike provided a pathway for getting to an agreed post-mining land use as the approach’s inherent anthropic focus provides a way to include community perspectives. In the Australian case, the recreation values sought by forest users had not been returned in rehabilitated mined areas, although it was clear that forest users’ perspectives were strongly influenced by historical rehabilitation efforts, which have been transcended by recent practices. Regulators saw value in using ecosystem services assessment methods to both plan the mine closure and monitor the progress of rehabilitation as a way to demonstrate social benefits rather than solely ecological results. In both countries, regulators agreed that results analysis of rehabilitation practices was poorly done. While Brazilian regulators saw ecosystem services as an opportunity to fill some current gaps in rehabilitation practices, such as stakeholder engagement, the Australian regulators believed that the planning process already made implicit use of ecosystem services. In both cases, the actual biophysical basis of rehabilitation practices was found to be robust, but taking an ecosystem services approach to mine closure planning enhanced the process and generated valuable insights for guiding post-mining land-use determinations. Overall, the study demonstrates that meeting regulatory requirements for rehabilitation, as measured by ecological indicators, does not automatically correlate with acceptable social outcomes

Modelling the net environmental and economic impacts of urban nature-based solutions by combining ecosystem services, system dynamics and life cycle thinking: An application to urban forests

Nature-based solutions (NBS) are gaining relevance as sustainable urban actions because of their potential to provide multiple benefits in the form of ecosystem services (ES), and thus mitigate urban challenges. This paper presents an original semi-dynamic modelling framework that simultaneously considers i) ES supply and demand dynamics, ii) negative environmental impacts, externalities, and financial costs derived from NBS, and iii) life cycle NBS impacts beyond the use phase. Compared to other models, it also aims to be valuable for urban planning actions at site level, i.e., for evaluating the net impacts of specific urban NBS projects. To validate the modelling framework, a proof-of-concept model for urban forests is developed and tested for a case study in Madrid (Spain). The modelling framework is split in two interrelated parts: foreground (dynamic modelling) and background (static modelling). In the foreground, the environmental impacts derived from the use phase of an NBS project are quantified considering its spatio-temporal dynamism, by making use of system dynamics. In the background, the environmental impacts derived from the rest of the life cycle phases of the NBS are quantified making use of steady state life cycle impact assessment. The net economic impact of the NBS project, considering both financial values and externalities, is eventually calculated in the background encompassing all the life cycle phases. Results from the case study illustrate how planning, design, and management decisions over the entire life cycle of an urban forest can influence the net environmental and economic performance of this type of NBS. A discussion is provided to inform on how the modelling framework can help moving beyond the state-of-the-art, and how the derived model can be used for sustainability assessments of urban NBS projects

Forest landscape restoration in the drylands of Latin America

Forest Landscape Restoration (FLR) involves the ecological restoration of degraded forest landscapes, with the aim of benefiting both biodiversity and human well-being. We first identify four fundamental principles of FLR, based on previous definitions. We then critically evaluate the application of these principles in practice, based on the experience gained during an international, collaborative research project conducted in six dry forest landscapes of Latin America. Research highlighted the potential for FLR; tree species of high socioeconomic value were identified in all study areas, and strong dependence of local communities on forest resources was widely encountered, particularly for fuelwood. We demonstrated that FLR can be achieved through both passive and active restoration approaches, and can be cost-effective if the increased provision of ecosystem services is taken into account. These results therefore highlight the potential for FLR, and the positive contribution that it could make to sustainable development. However, we also encountered a number of challenges to FLR implementation, including the difficulty of achieving strong engagement in FLR activities among local stakeholders, lack of capacity for community-led initiatives, and the lack of an appropriate institutional and regulatory environment to support restoration activities. Successful implementation of FLR will require new collaborative alliances among stakeholders, empowerment and capacity building of local communities to enable them to fully engage with restoration activities, and an enabling public policy context to enable local people to be active participants in the decision making process. © 2012 by the author(s). Published here under license by the Resilience Alliance

Assessing habitat loss, fragmentation and ecological connectivity in Luxembourg to support spatial planning

The increasing global population requires new infrastructure and urban development, and these land use changes have an impact on habitats and their ecological connectivity. To anticipate and minimise these impacts, environmental and urban planners require tools and methods that they can use at early planning stages. This paper investigates and selects landscape ecology techniques that can be used by planners to assess the effects in terms of changes in habitat loss, fragmentation and ecological connectivity due to expected land use changes. The selected techniques were tested in Luxembourg. Twelve landscape metrics, four connectivity indices, and one connectivity model were selected based on their straightforwardness, widespread application, and accessibility. Land cover maps and proposed areas of urban development up to 2030 were used as input data, together with adapted resistance surfaces from previous studies and a matrix of presence/absence for six target species. The combined analysis reveals a trend of increasing habitat fragmentation and loss of habitats, as well as a reduction of ecological connectivity with regard to all the targeted species, and suggests that this trend will likely continue in the near future. The selected landscape metrics, connectivity indices, the connectivity model and the software used to run them makes the abovementioned techniques easy to use by non-experts, and their combination helps to reduce some of the limitations of each individual technique. Both aspects might be useful in order to mainstream the use of landscape ecology techniques in spatial planning processes

Nexus between nature-based solutions, ecosystem services and urban challenges

Nature-based Solutions (NBS) are increasingly promoted to support sustainable and resilient urban planning. However, design and planning urban NBS targeted at the needs of the local context require knowledge about the causal relationships between NBS, ecosystem services (ES) and urban challenges (UC) This paper aims at contributing to this knowledge, by systematically identifying nexuses (i.e. qualitative links) between UC, ES and NBS, and describing plausible causal relationships. A conceptual UC-ES-NBS criteria framework was built, and used to guide a two-step systematic literature review on current UC and on the supply of ES by urban NBS. This was followed by a non-systematic literature review, which complemented the previous one by unveiling knowledge gaps on the biophysical and social processes and attributes on which specific ES classes depend. The non-systematic review was also used to identify additional NBS. The UC review identified 18 UC and 58 sub-challenges, and illustrated which UC were more studied, according to the type of literature and environmental and socio-economic attributes of urban contexts. The ES review led to the development of an urban NBS classification, and supported the identification of UC-ES and ES-NBS nexuses, which were analysed and classified into four groups of causal relationship. For the nexuses identified as direct plausible causal relationship, the main processes and attributes on which the supply of specific ES depend were pointed out. Relationships between UC, ES, NBS, processes, and attributes were represented in the form of network diagrams. Our results can be used to support urban policies aimed at mainstreaming NBS and as a basis to further understand UC-ES-NBS relationships

Mapping and assessing ecosystem services for sustainable policy and decision-making in Eritrea

The mapping and assessment of ecosystems and their services (MAES) is key to inform sustainable policy and decision-making at national and sub-national levels. Responding to the paucity of research in sub-Saharan Africa, we conduct a pilot study for Eritrea that aims to map and assess the temporal dynamics of key ecosystems and their services. We reviewed policy and legal documents, analyzed land cover changes and estimated the potential for ecosystem services supply through an expert-based matrix approach. Our results showed that from 2015 to 2019, the potential supply of the ecosystem services analyzed (e.g., crop provisioning, water supply and recreation) increased, with the exception of wood supply. Overall, our study presents policy-relevant insights as to where to conserve, develop, or restore ecosystem services supply in Eritrea. Our approach is transferable to similar data scarce contexts and can thereby support policies toward more sustainable land development for people and nature

Dedicated versus mainstreaming approaches in local climate plans in Europe

Cities are gaining prominence committing to respond to the threat of climate change, e.g., by developing local climate plans or strategies. However, little is known regarding the approaches and processes of plan development and implementation, or the success and effectiveness of proposed measures. Mainstreaming is regarded as one approach associated with (implementation) success, but the extent of integration of local climate policies and plans in ongoing sectoral and/or development planning is unclear. This paper analyses 885 cities across the 28 European countries to create a first reference baseline on the degree of climate mainstreaming in local climate plans. This will help to compare the benefits of mainstreaming versus dedicated climate plans, looking at policy effectiveness and ultimately delivery of much needed climate change efforts at the city level. All core cities of the European Urban Audit sample were analyzed, and their local climate plans classified as dedicated or mainstreamed in other local policy initiatives. It was found that the degree of mainstreaming is low for mitigation (9% of reviewed cities; 12% of the identified plans) and somewhat higher for adaptation (10% of cities; 29% of plans). In particular horizontal mainstreaming is a major effort for local authorities; an effort that does not necessarily pay off in terms of success of action implementation. This study concludes that climate change issues in local municipalities are best tackled by either, developing a dedicated local climate plan in parallel to a mainstreamed plan or by subsequently developing first the dedicated and later a mainstreaming plan (joint or subsequent “dual track approach”). Cities that currently provide dedicated local climate plans (66% of cities for mitigation; 26% of cities for adaptation) may follow-up with a mainstreaming approach. This promises effective implementation of tangible climate actions as well as subsequent diffusion of climate issues into other local sector policies. The development of only broad sustainability or resilience strategies is seen as critical.We thank the many council representatives that supported the datacollection. Special thanks to Birgit Georgi who helped in setting up this large net work of researchers across the EU-28. We also thank the EU COST Action TU 0902 (ledbyRichardDawson) that established the core research network and the positive engagement and interaction of th emembers of this group. OH is Fellow of the Tyndall Centre for Climate Change Research and was funded by the UK EPSRC LC Transforms: Low Carbon Transitions of Fleet Operations in Metropolitan Sites Project (grant number EP/N010612/1). EKL was supported by the Ministry of Education, Youth and Sports, Czechia, within the National Sustainability Program I (NPU I) (grant number LO1415). DG ac-knowledges support by the Ministry of Education, University and Research (MIUR), Italy ("Departments of Excellence" grant L. 232/2016). HO was supported by the Ministry of Education and Research, Estonia (grantnumberIUT34-17). MO acknowledges funding from the Ministry of Economy and Competitiveness (MINECO), Spain (grant number IJCI-2016-28835). SS acknowledges that CENSE's research is partially funded by the Science Foundation, Portugal (grant number UID/AMB/04085/2019). The paper reflects only the views of the authors. The European Union, the European Environment Agency or other supporting bodies are not liable for any use that may be made of the information that is provided in this manuscript

A framework for assessing and implementing the co-benefits of nature-based solutions in urban areas

To address challenges associated with climate resilience, health and well-being in urban areas, current policy platforms are shifting their focus from ecosystem-based to nature-based solutions (NBS), broadly defined as solutions to societal challenges that are inspired and supported by nature. NBS result in the provision of co-benefits, such as the improvement of place attractiveness, of health and quality of life, and creation of green jobs. Few frameworks exist for acknowledging and assessing the value of such co-benefits of NBS and to guide cross-sectoral project and policy design and implementation. In this paper, we firstly developed a holistic framework for assessing co-benefits (and costs) of NBS across elements of socio-cultural and socio-economic systems, biodiversity, ecosystems and climate. The framework was guided by a review of over 1700 documents from science and practice within and across 10 societal challenges relevant to cities globally. We found that NBS can have environmental, social and economic co-benefits and/or costs both within and across these 10 societal challenges. On that base, we develop and propose a seven-stage process for situating co-benefit assessment within policy and project implementation. The seven stages include: 1) identify problem or opportunity; 2) select and assess NBS and related actions; 3) design NBS implementation processes; 4) implement NBS; 5) frequently engage stakeholders and communicate co-benefits; 6) transfer and upscale NBS; and 7) monitor and evaluate co-benefits across all stages. We conclude that the developed framework together with the seven-stage co-benefit assessment process represent a valuable tool for guiding thinking and identifying the multiple values of NBS implementation

An ecosystem service approach to license new run of the river hydropower plants

Freshwater ecosystems provide several services (ES) to society. Hydropower production is one of the most relevant ES supported by Alpine rivers, and it is often in conflict with other river uses and services. Recently, the demand by local authorities, public or private agencies for new small hydropower plants have been increasing, and new conflicts have been arousing. We propose an approach to model the alterations of selected ES which integrates hydrological and habitat models and evaluates possible variations of the selected ES under different withdrawal scenarios. The case-study is the Noce River, a gravel-bed river in the Italian Alps (Trentino, North East Italy) which is subject to hydropeaking. We selected four ES: habitat for juvenile and adult marble trout as biodiversity proxy, rafting as recreational services, and small hydropower production as provisioning service. We evaluated the variations of these services for maximum and no hydropower production, chosen as different boundary conditions. Moreover, we simulated the presence of four new different small hydropower plants with increasing withdrawals. Large hydropower is the key driver, affecting all the selected ES. Small hydropower decreases the potential for rafting up to 64%, while it is often negligible for other services